WASHINGTON (USA TODAY) -- Amid the low enrollment numbers for health insurance via
the HealthCare.gov website, the Obama administration found one bright
Almost 400,000 people have learned they are
eligible to enroll in the states' Medicaid programs, and the numbers are
high even in Republican-dominated states that have chosen not to expand
President Obama highlighted the Medicaid enrollment
numbers Thursday, even as he took blame for the poor early performance
of the health exchanges and for misleading some Americans that their
health care policies would not change. Obama said the 396,000 new
enrollees for Medicaid are something "that's been less reported on, but
it shouldn't be.
"Americans who are having a difficult time, who
are poor, many of them working, may have a disability; they're Americans
like everybody else, and the fact that they are now able to get
insurance is going to be critically important."
Americans selected private health care plans in October, the first month
the state and federal health exchanges were open - one-fourth the
number who were determined eligible for Medicaid.
That's a boon
for needy Americans seeking help for their health care, but an early
sign the Affordable Care Act is so far more of a social welfare program
than a way to get people to buy their own health insurance. Still,
health experts say, their ability to get insurance could drive down
everyone else's costs.
The expansion included in the law allows
states to provide Medicaid coverage for adults who make less than 138%
of the poverty level for three years with the federal government paying
all of the extra costs. After three years, the federal share will remain
90% and the states will pay 10% of the expansion costs. Twenty-five
states have so far declined to expand Medicaid, citing higher costs or
opposition to the Affordable Care Act.
North Carolina, which chose
not to expand Medicaid, determined 7,404 people were eligible for
Medicaid, while about 1,600 have chosen an insurance plan through the
"Even in a state where we didn't expand, more
people signed up for Medicaid," said Don Taylor, associate professor of
public policy at Duke University's Sanford School of Public Policy. But
he said that "might be expected" when the coverage is free.
the exchanges are working properly, it's hard to tell how higher
Medicaid enrollments will mix with the private insurance market or if
Medicaid will somehow overwhelm the health care system with charity
cases, Taylor said.
"It's a legitimate worry, but the only way to really know is to live through the next few months," he said.
are several reasons for the growth in Medicaid patients, said Sara
Dash, a researcher at Georgetown University's Health Policy Institute.
• The "welcome mat" effect comes when people already
know Medicaid is available, but they don't know they're eligible until
they visit an exchange site and enter their information.
• The Affordable Care Act required the states to streamline the enrollment process.
• It's just easier to sign up for Medicaid because beneficiaries don't have to compare plans and pay a fee.
when the federal website's not working, that's kind of obviously not
easy," Dash said. "But I think there are probably millions of people
waiting in the wings for the private plans, even in the states where the
websites are working fine."
Ultimately, she said, the more people
who sign up for Medicaid, the better because recent research shows
people who receive preventive health care, as well as those who learn to
control issues like diabetes or heart disease, cost the health care
"It means you have a whole lot of low-income people who didn't have insurance before who have it now," she said.
Washington state, which expanded its Medicaid program, 48,196 were
determined eligible for Medicaid or the Children's Health Insurance
Program, federal records show.
State officials expected higher
Medicaid enrollment because a lot of people were already eligible for
the program and just didn't know it, said Michael Marchand, spokesman
for Washington's health exchange.
For the private plans, 9,000
people have initiated payment, Marchand said, and 40,000 have chosen a
plan but haven't chosen a payment option yet.
officials expect 1 million people to enroll in the state's Medicaid
program. So far, 72,000 people have qualified for Medicaid in
California, said Norman Williams, deputy director for public affairs at
the California Department of Health Care Services.
But he sees it
as a sign of the future for the country, as well. In the first 12 days
of November, California saw its enrollment for private plans match the
entire month of October, Williams said. About 2,000 people per day
enrolled, for a total of nearly 60,000.
"The relative success story in California will be important to show the system is working," he said.
traveled Thursday to Ohio, where Republican Gov. John Kasich recently
engineered expanding Medicaid by bypassing the GOP-led state Legislature
and using an obscure state board to approve the acceptance and spending
of the federal money to boost the program.
In the first month of
the exchanges, 1,150 Ohioans used the health care exchange to select
private insurance, while 7,535 were found eligible for Medicaid.
Levine, executive director of UHCAN (Universal Health Care Action
Network) Ohio, a health care advocacy group, said people are
"intrigued," but that they don't understand that they're eligible.
of the people who look for affordable coverage assume they're not
eligible for Medicaid," she said. "They're working two and three jobs,
and they think Medicaid is for people on food stamps."
She said people have told her they're relieved - and with 275,000 people newly eligible for Medicaid, she's hearing it a lot.
for the private plans, "A lot of people are shopping around," she said.
"We think as we get closer to December 15, the activity's going to pick